Commentary | PERSPECTIVE ON THE DOW CORNING SETTLEMENT

Fooling Mother Nature and Then Suing Dow

Women who get breast implants for nonmedical reasons weigh less, drink more and have more sexual partners.

July 12, 1998|KATHERINE DOWLING | Katherine Dowling is a family physician

A good decade ago, a homeless lady who was both charming and delusional requested an exam to begin the process of becoming pregnant. She refused to give credence to my explanation that postmenopausal women in the sixth decade of life attempting to conceive for the first time were dealing with rather long odds, even though a few such cases have been biblically documented. During her exam, however, it became evident that she had some interesting equipment for snaring a potential father for her hoped-for offspring: She had breast implants.

The anthropology of "augmentation mammoplasty," both in my long-ago patient and in other women, is often a reaffirmation of woman as a sex object. Sometimes, it is true, this operation is valid reconstruction due to breast cancer or to trauma. No one would deny that such reconstruction is of both physiologic and psychologic benefit to the victims of such tragedies and worth the risk of the surgery.

But why would a woman whose architecture is normal, albeit minimal, choose the risks of an operation and of having a foreign body sitting on her rib cage? And if she does desire to take those risks, should she expect to be compensated for any and all ills which might subsequently befall her, whether related or not to the procedure?

A recent article in the Journal of the American Medical Assn. took a scientific look at the personality characteristics of women who augment themselves as compared with those who choose not to fool Mother Nature. The augmentees were found to be more likely to consume more alcoholic drinks per week, to have had a greater lifetime number of sexual partners, to have given birth at a younger age, to have terminated pregnancies and to use hair dyes. They also tended to be skinnier. All of these personality characteristics suggest a somewhat more hedonistic approach to life, as well as a desire to impress the opposite sex with one's physical, as opposed to one's intellectual or moral attributes.

By and large, women choose augmentation mammoplasty to conform to what they perceive as the male image of the well-constructed female. This choice, with its concomitant risks is of course constitutionally protected. But if something does go wrong, the consequences are a part of the package.

Dow Corning Corp., a silicone breast implant maker trapped in a $3.2 billion payout to skilled class-action lawyers and their protegees and currently dealing with bankruptcy issues as a consequence, maintains that silicone implants do not cause the diseases attributed to them. Hard science is pretty much on the company's side. The litigation over silicone implants is having a chilling ripple effect on the manufacture of other types of implants, one that could impact the availability of products for patients who have a medical rather than a cosmetic need for such devices.

But the bedrock issue here may be the attitude of a society that is so coddled and spoiled that it refuses to accept the consequences of freely made decisions. Its members would establish blame and obtain monetary recompense for every malady that comes along. Proving cause and effect is not even a requirement for obtaining compensation.

An approach to product liability that holds that when something bad happens to you, the product is assumed to have caused that adverse effect whether or not scientific data support such an assumption, is one that necessarily frustrates innovative product development. But perhaps a little good will come of Dow Corning's legal crucifixion. Maybe there will be a little less incentive to tamper with the human body when its specifications fall short of Miss Universe.